• Title/Summary/Keyword: Chronic disease management

검색결과 1,909건 처리시간 0.031초

자조집단 활동과 자기효능성 증진법을 이용한 수중운동 프로그램이 류마티스 관절염 환자의 통증, 생리적 지수 및 삶의 질에 미치는 영향 (An Effect of Aquatic Exercise Program with Self-help Group Activites and Strategies for Promoting Self-efficacy on Pain, Physiological Parameters and Quality of Life in Patients having Rheumatoid Arthritis.)

  • 김종임
    • 근관절건강학회지
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    • 제1권1호
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    • pp.1-30
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    • 1994
  • Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

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12세 미만 아토피 피부염 어린이의 에너지 및 영양소적정섭취 수준 평가: 2013-2015년 국민건강영양조사 자료를 바탕으로 (Evaluation of nutritional status and adequacy of energy and nutrient intakes among atopic dermatitis children under 12 years of age: based on Korea National Health and Nutrition Examination Survey data (2013-2015))

  • 김혜원;김지명
    • Journal of Nutrition and Health
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    • 제53권2호
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    • pp.141-154
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    • 2020
  • 본 연구에서는 국민건강영양조사 제 6기 1-3차년도 (2013년-2015년) 참여자 중 1-12세 미만인 어린이의 AD 여부와 에너지 및 영양소 적정섭취비율과의 관계를 분석하였다. AD군은 전체 연구대상자의 약 15.2%로, 남아 비율이 높았으며, non-AD군보다 평균나이가 약 0.7세 더 많았고, 나이를 세분화하여 비교했을 때, 나이가 들수록 AD 환아 수가 증가하였다. 신체 계측 결과, AD군이 non-AD군보다 신장과 체중 값이 더 컸지만, BMI는 군 간의 차이를 보이지 않았다. AD 여부와 식품군 및 영양소섭취 현황을 나이와 성별을 보정하여 비교한 결과, 두 군 간의 유의미한 차이가 있는 영양소는 없었다. 다만, 칼슘의 RNI 대비 섭취비율이 두 군 모두에게서 약 70% 수준으로 나타났는데, 이는 우리나라 어린이의 전반적인 칼슘 섭취량 부족에서 온 것으로 볼 수 있다. AD 여부에 따른 에너지와 영양소 섭취량의 차이는 나타나지 않았으나, KDRIs에 따른 적정섭취비율을 비교한 결과, AD군에서 지방과 비타민 C를 적정한 수준으로 섭취하는 비율이 더 높았고, 부족하거나 과잉으로 섭취하는 비율은 더 낮았다. AD 위험도와 에너지 및 영양소 적정섭취비율과의 관계를 분석하였을 때에는 지방은 과잉으로 섭취했을 경우, 비타민 C는 부족하거나 과잉으로 섭취했을 경우 AD 위험도가 감소하였다. 결론적으로, 어린이에게서 AD는 지방과 비타민 C의 영양소섭취비율과 관련이 있는 것으로 보이며, 이러한 결과는 AD 관리를 위한 식이 제한의 영향도 있을 것으로 예상한다. 이에 대해 좀 더 명확하게 인과관계를 규명하기 위한 추가 연구가 요구된다.

Serum Vitamin D Status in Iranian Fibromyalgia Patients: according to the Symptom Severity and Illness Invalidation

  • Maafi, Alireza Amir;Ghavidel-Parsa, Banafsheh;Haghdoost, Afrooz;Aarabi, Yasaman;Hajiabbasi, Asghar;Masooleh, Irandokht Shenavar;Zayeni, Habib;Ghalebaghi, Babak;Hassankhani, Amir;Bidari, Ali
    • The Korean Journal of Pain
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    • 제29권3호
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    • pp.172-178
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    • 2016
  • Background: This study was designed to assess serum vitamin D status (25-OHD) in the fibromyalgia (FM) patients and to compare it with a healthy control group. It also aimed to investigate the correlation of serum vitamin D level with FM symptom severity and invalidation experiences. Methods: A total of 74 consecutive patients with FM and 68 healthy control participants were enrolled. The eligible FM patients completed the Illness Invalidation Inventory (3*I), the Revised Fibromyalgia Impact Questionnaire (FIQR) and a short-form health survey (SF-12). Venous blood samples were drawn from all participants to evaluate serum 25-OHD levels. Mann-Whitney tests and multiple logistic regression analyses were performed and Spearman's correlations were calculated. Results: 88.4% of FM patients had low levels of serum 25-OHD. FM patients had significantly higher level of serum 25-OHD than the control group ($17.24{\pm}13.50$ and $9.91{\pm}6.47$ respectively, P = 0.0001). There were no significant correlations between serum 25-OHD levels and the clinical measures of disease impact, invalidation dimensions, and health status. Multiple logistic regression analyses revealed that an increased discounting of the disease by the patient's spouse was associated with a 4-fold increased risk for vitamin D deficiency (OR = 4.36; 95% CI, 0.95-19.87, P = 0.05). Conclusions: This study showed that although high rates of vitamin D insufficiency or deficiency were seen among FM patients and healthy non-FM participants, but it seems there was no intrinsic association between FM and vitamin D deficiency. Addressing of invalidation experience especially by the patient's spouse is important in management of FM.

The Survival Rate of Korean Patients with COPD with or without Acute Exacerbations

  • Uh, Soo-Taek;Lee, Ji-Yeon;Koo, So-Mi;Kim, Yang-Ki;Kim, Ki-Up;Park, Jong-Sook;Park, Sung-Woo;Jang, An-Soo;Kim, Do-Jin;Choi, Jae-Sung;Na, Joo-Ok;Suh, Ki-Hyun;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • 제70권6호
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    • pp.474-481
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    • 2011
  • Background: Chronic obstructive pulmonary disease (COPD) is characterized by air low limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. Methods: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. Results: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP>3 mg/L than in those with CRP ${\leq}3$ mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). Conclusion: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.

Complications and Carcinogenic Effects of Mustard Gas - a Systematic Review and Meta-Analysis in Iran

  • Panahi, Yunes;Gholami, Nasrin;Ghojazadeh, Morteza;Moslemi, Farnaz;Naghavi-Behzad, Mohammad;Azami-Aghdash, Saber;Ghaffari, Alireza;Piri, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7567-7573
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    • 2015
  • Background: Catastrophic effects of mustard gas as a chemical warfare agent have always been a major problem for those exposed to this agent. In this meta-analysis it was tried to evaluate carcinogenesis, ocular, cutaneous and respiratory complications of mustard gas exposure among Iranians who had been exposed to this agent during the Iran-Iraq war. Materials and Methods: In this meta-analysis, the required data were collected using keywords "mustard gas", "sulfur mustard", "cancer", "neoplasm", "respiratory complications", "ocular complications", "lung disease", "chronic complication", "eye", "skin", "cutaneous complication", "carcinogenesis" and their combination with keywords "Iran", "Iranian", "prevalence", "mortality" and their Farsi equivalent terms from the databases of SID, Iranmedex, Magiran, Pubmed, Science Direct, Google Search engine, Gray Literature and Reference of References. To determine the prevalence of each complication and perform meta-analysis, CMA: 2 (Comprehensive Meta-Analysis) software with a randomized model was used. Results: Of the 542 articles found, 7 national articles, consistent with the aims of this study were selected. Meta-analysis of seven papers revealed that cancer risk, especially cancer of the respiratory system was elevated, so that the relative risk (RR) of cancer role of mustard gas was inconsistent from 2/1 to 4 in this survey. Also prevalence of delayed skin disorders due to sulfur mustard was 94.6%, pulmonary complications 94.5% and ocular complications 89.9%. The incidence of various cancers in victims exposed to mustard gas was 1.7% worldwide where the rate was 2.2% in Iranian victims of the Iraq-Iran war. Conclusions: Based on present study the prevalence of delayed mustard gas related cutaneous, pulmonary and ocular complications is above 90% and risk of carcinogenesis is higher in comparison to worldwide statistics. This may suggest need for long-term and persistent follow-up and rehabilitation procedures for populations exposed to this agent.

퇴행성관절염 여성노인들의 보완대체요법 이용 유무에 따른 건강증진행위 비교 (A Comparative Study on Health Promotion Behaviors by Complementary Alternative Therapy Utilization of Elderly Women with Osteoarthritis)

  • 김정숙;박정숙
    • 디지털융복합연구
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    • 제16권2호
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    • pp.451-459
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    • 2018
  • 본 연구의 목적은 퇴행성관절염 여성노인들의 보완대체요법 이용 유무에 따른 건강증진행위의 차이를 비교하는 것이다. 본 연구의 대상자는 총 621명으로 C도 1개 도시 보건소와 보건지소에 등록된 퇴행성관절염 여성노인이다. 자료 분석 방법은 보완대체요법 이용률은 빈도와 백분율로, 대상자의 일반적 특성 및 질병관련 특성에 따른 보완대체요법 이용차이는 ${\chi}^2$ 검정, 보완대체요법 이용유무에 따른 건강증진행위 정도는 t-test, ANOVA로 분석하였다. 연구결과 전체 대상자 621명의 보완대체요법 사용률은 61.7%였으며 보완대체요법 이용유무에 따른 두 집단간 건강증진행위 영역에서 운동(p<.001), 건강책임(p<.001), 자아실현(p=.016)은 유의한 차이가 있었다. 따라서 퇴행성관절염 여성노인들의 보완대체요법 이용 유무에 따른 건강증진행위가 차이가 있으므로 보완대체요법의 안전하고 올바른 사용에 대한 상담 및 지도가 필요하고 건강증진 전략행위 개발이 필요함을 알 수 있다.

일 지역 대학생의 피로와 건강증진 생활양식과의 관계분석 (The correlation analysis between fatigue and health promoting life style among a rural college students)

  • 장희정
    • 기본간호학회지
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    • 제6권3호
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    • pp.477-492
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    • 1999
  • The disease patterns among the Korean was shifted from acute and infectious diseases to chronic diseases. According to the these disease patterns trends, people have concerned about the health promotion and health behaviors. Pender's(1996) revised health promotion model(HPM) is consist of three categories; Individual characteristics and experiences, Behavior-specific cognitions and affect, behavioral outcome. Of these categories, individual characteristics and experiences, this category of variables is considered to be of biological, psychological and socio-cultural personal factors, especially, individual fatigue. Futhermore. these variables constitute a critical core for nursing intervention, as they are subject to modification through nursing actions. But there is no few the research of the relationship between the fatigue and health promotion. Therefore, the purpose of this study is to investigate the correlation between the fatigue and health promoting life style among a rural college students. Additionally, this descriptive correlational study identified the relation of demographic factors and fatigue, health promoting life style. From June 20 to 26, 1998, a convenience sample of 270 college students completed the questionnaire of the fatigue and health promoting life style profile which were developed by the Yoshitake(1978) and Walker, et al.(1987), respectively. The descriptive correlational statistics, mean, t-test, ANONA, Pearson correlation coefficient were used to analyze the data gathered with SAS pc+ program. The results were as it follows: 1. The average fatigue score of the subjects was $64.93{\pm}12.89$. Fatigue scores by subcategory were physical symptoms($23.5{\pm}4.87$). psychological symptoms($22.11{\pm}4.66$) and neuro-sensory symptoms($19.32{\pm}5.14$). With the respect to the demographic characteristics of the subjects, there were statistically significant differences between the demographic factors and fatigue, especially, sex(t==3.69 p<0.01), major(t=-2.89 p<0.01). the experience of family illness(t=2.76 p<0.01). 2. The average health promoting life style item score of the subjects was $2.33{\pm}0.33$. In the subcategories, the highest degree of performance was self-actualization(2.94), following interpersonal support(2.81). stress management(2.33), exercise(2.20), nutrition(2.10), and the lowest degree was health responsibility(1.73). There were the significant differences on the learning of health education(t=2.00 p<0.01). religion(F=3.01, p<0.05), circle activity(t=2.07, p<0.05), nutrition control(t=5.25, p<0.01) of demographical factors with the health promoting life style. 3. The correlation between the fatigue and health promoting life style made statistically no significance(r=-0.09731, p>0.05). But there was negative significant relationship between health promoting life style and psychological symptom as a fatigue subcategory(r=-0.15721, p<0.05). The self-actualization showed negative significant correlation with all fatigue subcategory. The health responsibility showed significant relationship with total fatigue(r=0.13050. p<0.05). For further research, it suggests to replicate the correlational and causal study between the fatigue and the health promoting life style using the another fatigue scale which is able to measure the subjective and objective fatigue degree. And it needs to develop the nursing intervention program for maintaining and promoting the health behavior as well as for decreasing the college students's fatigue.

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수면과 관련된 호흡장애 (Sleep-Related Respiratory Disturbances)

  • 문화식
    • 수면정신생리
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    • 제2권1호
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    • pp.55-64
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    • 1995
  • 수면중에는 여러 가지 호흡생리의 변화가 나타나는데, 호흡의 수의적 조절은 경미하고 대부분 대사성조절에 의해 호흡이 유지되며, 탄산가스와 산소변화에 의한 화학자극 및 호흡기계통의 기계적 자극에 대한 환기반응이 감소하고, 늑간근 및 상기도근육들과 같은 보조호홉근의 기능이 억제되며, 체위변동 즉 누운 자세에서는 여러 가지 호흡기능의 변화가 온다. 이러한 호흡생리의 변화로 정상인에서도 수면 중에는 경미한 환기장애(저환기)를 보일 수 있으며, 수면 무호흡이 있는 경우에는 환기장애가 더욱 현저하다. 환기장애 즉 만성 폐포저환기를 동반하는 질환은 심폐질환 이외에도 여러 가지가 있으며 수면 무호흡 증후군은 환기장애를 일으키는 중요한 원인중의 하나이다. 만성 폐포저환기를 보이는 환자는 원인질환에 관계없이 수면중에 환기장애가 더욱 심해지며 특히 수면 무호흡이 빈번하게 동반되는 경우에는 중증의 임상경과를 보인다. 폐쇄성 수면 무호흡증후군 환자는 수면중에 반복되는 저산소증과 각성반응으로 수면장애증상 이외에도 전신 고혈압과 심부정맥이 흔히 동반되며, 주간에도 저산소증을 보이는 심폐질환자에서 수변 무호흡증후군이 동반되는 경우 폐동맥고혈압과 폐성심이 올 수 있다. 이러한 심폐혈관계 합병증은 수면 무호흡증후군 환자의 장기사망율을 높이는 중요한 원인이 되며, 중증 환자의 경우 수면중에 급사할 수도 있다. 폐쇄성 수면 무호흡증후군 환자의 심폐혈관계 합병증과 장기사망율을 감소시키기 위해서는 적절한 치료법이 요구되며, 환기장애(만성 폐포저환기)의 다른 원인질환이 함께 있는 경우에는 수면 무호흡의 치료와 병행하여 이들 질환의 치료를 동시에 실시하여야 한다.

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척주관협착증 환자의 Beck Depression Inventory 점수와 이와 관련된 요인들의 분석 (Beck Depression Inventory Score and Associated Factors in Korean Patients with Lumbar Spinal Stenosis)

  • 김애라;서보병;김진모;배정인;장영호;이용철;강철형;정성원;홍지희
    • The Korean Journal of Pain
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    • 제20권2호
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    • pp.138-142
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    • 2007
  • Background: Depression is a frequent comorbid disease of chronic pain patients. This study was conducted to evaluate the prevalence of depression and to correlate associated factors and depression in patients with lumbar spinal stenosis. Methods: The data of this survey was collected from 97 patients that visited our pain clinic for the management of lumbar spinal stenosis. Depression was examined by a self-reported survey using the Korean version of the Beck Depression Inventory (BDI). The Oswestry Disability Index (ODI) and the life satisfaction scale score were also obtained. Demographic and clinical characteristics (including spouse status, employment status, smoking status, the number of patients with multiple painful areas, the number of patients with combined disease, pain duration, visual analogue scale, Roland 5-point scale and walking distance) were obtained from an interview with the patient. The patients were divided into group N ($BDI{\leq}14$, n = 43) and group 0 (BDI > 14, n = 54) according to the BDI scale. Of the 97 patients, 55,7% had a high BDI score. Results: The patients in group N had a higher rate of employment (48.0%, P < 0.05) and had higher life satisfaction scale scores ($9.4{\pm}2.5$, P < 0.01) as compared to group D patients. The BDI score showed a close correlation with employment status and the life satisfaction scale. Conclusions: Many lumbar spinal stenosis patients had high BDI scores. Employment status and the life satisfaction scale were closely correlated with the BDI score.

당뇨병 환자의 삶의 질(EQ-5D)에 미치는 영향 요인 : 2019년도 제2기 한국 의료패널 조사를 중심으로 (Factors Influencing the Quality of Life (EQ-5D) of Patients with Diabetes Mellitus: Study Based on Data from the Second Annual Korea Health Panel survey (2019))

  • 김소현;조성현
    • 대한통합의학회지
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    • 제11권3호
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    • pp.99-114
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    • 2023
  • Purpose : The purpose of this study was to determine factors that affect the quality of life (QoL) of people with diabetes. We hope to provide a basis for intervention strategies for health promotion and related research among patients with diabetes in the field of physical therapy. Methods : We selected individuals diagnosed with diabetes who were aged 19 years or higher by using data from the 2019 Korean Health Panel survey and analyzed the results of 1,527 people. The influencing factors were sex, age, household income, marital status, age, education level, subjective health status, body mass index (BMI), smoking, drinking, regular exercise, experience of depression and anxiety, suicidal thoughts, stress, and frequency of walking (days/week). Frequency analysis, descriptive statistics, independent sample t-test, one-way analysis of variance, and multiple regression analysis were performed. Results : The EQ-5D score for QoL was .87 ± .12, with pain and discomfort being the most detrimental to the QoL of people with diabetes. In terms of patients characteristics, the QoL was lower among participants who were female, older, and separated/widowed/divorced; had an education level below middle school; had a poor subjective health status; were non-smokers and drinkers; and did not walk and exercise regularly, experienced a lot of stress, and experienced depression and anxiety; and had suicidal thoughts (p<.001). Being separated/bereaved/divorced; experiencing a lot of stress, depression, and anxiety; and having suicidal thoughts were negatively associated with QoL in people with diabetes (p<.01). On the other hand, age of 65 years or younger; graduation from high school, fair or better subjective health, regular exercise and alcohol consumption, and walking (days/week) were positively associated with QoL (p<.05). Conclusion : Regarding the QoL of patients with diabetes, intervention strategies should be formulated by considering general characteristics and disease-related characteristics. Among the various factors affecting QoL, the number of walking and regular exercise were found to be the factors that improved the QoL of patients with diabetes. These results can be used as a basis for the education and management of patients with diabetes in the field of physical therapy.